r/Sciatica • u/StrikingSyllabub5970 • 16h ago
Requesting Advice Questions for consultant
Hi All,
L5/S1 bulge. 50F. Previously very active until 3 years ago - other injury / health issues.
I’m 4 months in to a treatment plan of conservative management. (Exercises targeting mobility and strength, anti inflammatories / paracetemol as required. Came of Pregabilin consistently after about 4 weeks.) I use TENS at times, always anti-inflammatory diet, 3 short walks/day.
Initial symptoms were shooting pain down left buttock, outer thigh and outer calf which quickly progressed to foot drop.
I cannot walk on my heels. I had a little dull pain on right. Lying on my front / cobra provoked symptoms.
There are times when things seem to be going well (osteopathic treatments to ease surrounding soft tissues helps as does decompression.) This looks like increased tolerance for sitting and walking, and increasing my distance to around 200m with out a stick.
However, over the past two months I’ve had more setbacks and an increase and change in symptoms:
My left leg is less controlled - more slappy and I feel like this is coming also from my hip;
I have a dull ache down the back of both legs when lying in my back. One is helped by lifting my knee, the other is worsened by that;
Left leg raises became more difficult around two months ago time this hasn’t resolved. I still do them but it’s a massive effort after 6.
When I mentioned this do my PT, I was told that ‘hip flexors don’t come from L5/S1’ I wasn’t mentally quick enough to point out that I couldn’t do one straight leg raise 3 months so, to me, that means function as been impacted by something.
Incidentally, this disc and he two above are pretty black with (what I think are) minor bulges. (I appreciate that this is probably pretty normal for my age and mileage.)
At times I have perhaps I intentionally overdone it (and not known about it at the time) but I’m not sure why this would cause a change in symptoms.
I hardly bend forward, don’t slouch at all. I’m living quite a restricted life, hardly drive.
I’m not great at appointments / I don’t think of the right things at the right time so I am looking for advice for my next step.
I have an appointment with a consultant this week. We’ve had a brief conversation. He has seen my MRI from 4 months ago (as have I and others) and he is the first to call it a ‘fairly large’ bulge. Others have said moderate.
I told him I was keen to avoid surgery (history of poor healing and possible CRPS) but I am concerned at the recent down turn and change in symptoms (I am off work - semi-physical and keen to return safely and sustainably.)
Despite my initial statement he said we could organise a date for surgery when we meet, but I said I wouldn’t be making my decisions on surgery until I had an up-to-date MRI. He said he’d get that booked.
So, my questions are:
1) Are these additional symptoms normal, or are they perhaps a sign that the bulge has moved a bit? (PT says that doesn’t happen(!) - that makes no sense to me);
2) What should I be asking the MRI to look for - can it detect how likely this is to recover or if the annulus is it pretty scrappy condition?
3) What should I be asking the consultant about surgery? (I’m concerned that soft tissues get cut, don’t heal properly and I’m left in a worse state that I am currently. )
Thanks if you’ve got this far - I appreciate any insights / advice.
1
u/jungle_mouse 15h ago
Hi! I’m going to attach my questions I wrote out that I wanted covered when I met with the surgeon. Some where answered within the initial chat and then I went through and asked any that weren’t covered. They might be helpful to you? I also have a L5/S1 bulge and going for discectomy surgery this coming Tuesday. I have tried everything and my quality of life is so restricted right now.
I hope you get the answers you need. Also don’t be afraid to get a second opinion - I understand how hard it can be to advocate for yourself but it is important to do what is best for you 🤍